title: [Antidepressants, depression and suicide].
abstract: OBJECTIVE
  The goal of this paper is to analyse the complex relationship between antidepressants, depression and suicide.
  
  
  METHODS
  Review and synthesis of the Hungarian and English language international literature, published on this topic in the last 15 years.
  
  
  RESULTS
  Large-scale, retrospective and prospective, naturalistic ("real life") studies show that compared to patients without treatment antidepressants and mood stabilizers reduce the risk of completed and attempted suicide by about 80%. This anti-suicidal potential is significantly higher than the small increase in suicidality of patients taking antidepressants in placebo controlled randomized Phase II/III trials. New data show that based on clinical data this small subgroup can be identified and successfully treated using specific therapy.
  
  
  CONCLUSIONS
  Suicidal behaviour in patients taking antidepressants is mostly the consequence of the lack of antidepressant effect and is rarely the result of suicide-inducing potential of antidepressants. This rare latter case is most frequently the consequence of antidepressant monotherapy of bipolar depression. Appropriate use of antidepressants and mood stabilizers plays a key role in suicide prevention of patients with affective disorders.
authors.affiliation: Semmelweis Egyetem, Klinikai és Kutatási Mentálhigiénés Osztály, Budapest, Hungary. rihmerz@kut.sote.hu.
authors.forename: Zoltán
authors.initials: Z
authors.lastname: Rihmer
mesh_terms: D000341:Affective Disorders, Psychotic / Q000150:complications / Q000188:drug therapy*; D000928:Antidepressive Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000188:drug therapy; D003863:Depression / Q000150:complications / Q000188:drug therapy*; D003865:Major Depressive Disorder / Q000150:complications / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D006801:Humans; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D012189:Retrospective Studies; D013405:Suicide / Q000523:psychology; D013406:Suicide, Attempted / Q000517:prevention & control; D000092864:Suicide Prevention
chemical_list: D000928:Antidepressive Agents